ATLANTA...Former U.S. President Jimmy Carter announced today that cases of Guinea worm disease have reached an all-time low with fewer than 5,000 estimated cases remaining worldwide. To help eliminate the remaining cases, the Bill & Melinda Gates Foundation and the United Kingdom Department for International Development (DFID) announced new commitments totaling US$55 million to support the historic Carter Center-led eradication campaign.

"Guinea worm is poised to be the second disease eradicated from Earth, ending needless suffering for millions of people from one of the world's oldest and most horrific afflictions," said former U.S. President Jimmy Carter, founder of The Carter Center. "The reduction of Guinea worm cases by more than 99 percent proves that when people work together, great positive change is possible."

The $40 million grant from the Gates Foundation is the largest challenge grant in Carter Center history. It includes an outright contribution of $8 million and encourages other donor organizations and individuals to provide an additional $32 million, which the Gates Foundation will match one-to-one. The successful completion of the challenge will raise $72 million to finish Guinea worm eradication. Since 2000, the Gates Foundation has been a valued partner in the Center's Guinea Worm Eradication Program, inspiring an outpouring of contributions from the donor community during this landmark effort.

DFID generously pledged £10 million (approximately US$15 million) to support the Guinea worm eradication campaign, and its support will be matched by the Gates Foundation. Both the Gates Foundation and DFID grants will be shared between the Center and the World Health Organization (WHO).

"We have made substantial progress; many countries that previously had Guinea worm are now free of the disease. We must now push to eliminate it completely," said Douglas Alexander, the United Kingdom's international development secretary. DFID's £10 million pledge to the Center's Guinea worm efforts underscores the United Kingdom's commitment to promote sustainable development and eliminate world poverty. DFID has helped support the Center's efforts to wage peace and fight disease worldwide since 1997.

Tackling the Final Cases

Poised to be only the second disease in human history to be eradicated, Guinea worm disease (dracunculiasis) will be the first to be wiped off the face of the Earth without a vaccine or medicine. However, the last cases of an eradication campaign are the most difficult and expensive to eliminate. Although infected cases become fewer and far between, surveillance of countries, including the smallest communities in the most remote areas, needs to be intensified to prevent outbreaks and setbacks. In the case of Guinea worm disease, which has a one-year incubation period, there is a very high cost of maintaining a broad and sensitive monitoring system and providing a rapid response when necessary.

"At this stage of the campaign, we need to redouble case containment efforts and enforce strict surveillance activities to ensure Guinea worm disease eradication," said Dr. Margaret Chan, director general of the WHO. "The task is daunting and financially challenging, but achievable. To do this in the shortest time possible, we need more than ever, the exemplary support and commitment of existing and future partners to rid the world of one of its oldest scourges."

A water-borne disease, Guinea worm is transmitted only by drinking contaminated water. The presence of Guinea worm disease in a geographic area indicates abject poverty, including the absence of safe drinking water. Those affected by the disease are often unable to go to school, farm, or do other work, resulting in increased poverty. The disease can be controlled through simple measures, such as filtering all drinking water and educating people who are infected to take precautions to prevent transmission.

The Process of Eradication

The Carter Center provides technical and financial assistance to the national eradication programs to help stop transmission. The Center's role comes to an end in each country approximately one year after the last indigenous case is detected. At that point, the national ministry of health and the WHO work together to maintain a surveillance system for three years after the last known indigenous case. The WHO helps countries establish surveillance in Guinea worm-free areas even before the infection is halted nationwide. Since the Center's work began in 1986, six previously endemic countries have been certified by the WHO as free of Guinea worm disease, and eight additional countries that have stopped transmission are awaiting certification.

Remaining Cases by Country

Today, cases remain in only six African nations. When the eradication campaign began in 1986, there were an estimated 3.5 million cases in 20 nations in Africa and Asia. Since then, worldwide cases have been reduced by 99.7 percent.

The commitments announced today follow a year of great progress: There were only 9,585 cases of Guinea worm disease recorded in 2007, reduced from 25,217 cases in 2006. In 2007, both the Ghanaian and Sudanese programs, which together accounted for more than 95 percent of all cases in 2007, achieved individual milestones, slashing cases by more than half compared to 2006.

In the first 10 months of 2008, only 4,410 cases of Guinea worm disease were reported in Sudan, Ghana, Mali, Ethiopia, Nigeria, and Niger. Cases are expected to remain below 5,000 for the year. Two countries—Nigeria and Niger—already may have reported their last case. Today, southern Sudan, northern Ghana, and eastern Mali are the main foci of eradication efforts.

Cost-Effective Impact

"The drive to eradicate Guinea worm disease is one of the world's most impressive global health success stories," said Dr. Regina Rabinovich, director of infectious diseases development at the Gates Foundation. "Using simple inexpensive tools, The Carter Center and its partners have spared millions of people from the suffering caused by this disease."

Guinea worm eradication is considered one of the most cost-effective public health efforts due to its relatively simple intervention measures, such as health education, free cloth filter distribution, and BASF-donated ABATE® larvicide applications. To date, the Guinea worm eradication campaign has raised and invested an estimated $225 million in African communities.

Working together with thousands of community volunteers and the ministries of health in affected countries, the Guinea Worm Eradication Program has coordinated, engaged, and mobilized hundreds of partners. The Carter Center-led Guinea worm eradication campaign includes core partners — the WHO, the U.S. Centers for Disease Control and Prevention, UNICEF, and national programs — as well as governments, foundations, nongovernmental organizations, corporations, and individuals.

For more information and a Guinea worm video presentation, visitwww.cartercenter.org.

Up-to-date Guinea worm resources including, monthly case reporting, graphs, news articles, and human interest stories are available on the Center's site at www.cartercenter.org

THE CARTER CENTER:

"Waging Peace. Fighting Disease. Building Hope."
A not-for-profit, nongovernmental organization, The Carter Center has helped to improve life for people in more than 70 countries by resolving conflicts; advancing democracy, human rights, and economic opportunity; preventing diseases; improving mental health care; and teaching farmers in developing nations to increase crop production. The Carter Center was founded in 1982 by former U.S. President Jimmy Carter and his wife, Rosalynn, in partnership with Emory University, to advance peace and health worldwide. Please visit www.cartercenter.org to learn more about The Carter Center.